Anaphylaxis — immediate sequence

Epinephrine intramuscular in the mid-outer thigh, first, before anything else. Call for help and stop the suspected trigger. Lie the person flat with the legs raised; sitting up only if breathing is difficult; never stand them up. High-flow oxygen, large-bore IV access, fluid bolus. Repeat epinephrine every 5 to 15 minutes if needed. Antihistamines and corticosteroids are adjuncts only, never first. Observe for a biphasic reaction

• Antidotes to know
• Hyperkalemia — priorities
• Sepsis — first-hour actions
• Transfusion reaction — what to do
• Types of shock — recognition
• Epinephrine

Clinical content reviewed by Ducamelle Grégoire, Registered Nurse